Our heads are heavy objects, sometimes as much as twenty pounds, balanced on a small base of support (the neck). There are large numbers of small muscle groups that articulate or move our heads. These groups of muscles can be quite challenged and compromised during a whiplash, as they try to maintain balance during a violent or sudden occurrence.
Muscle spasm and pain will often develop following the injury; in some instances the muscle spasm and pain does not occur immediately, but may set in days later. This is sometimes the case with multiple injury sites to the body. In an auto accident, for example, there may be injuries to the shoulder, knee, and neck. If the pain sensations are stronger in the shoulder or the knee, these may be the primary and secondary pain locations. Therefore, the neck injury or whiplash may not be felt until later.
I have found this to be true in helping clients after an auto accident. When I performed Trigger Point Myotherapy release at a California HMO, I did so through this particular hospital’s Neurology Department. Many of my clients were workman’s comp cases who had lingering dysfunction from auto accidents. Often with a series of sessions, we could reduce the pain from their primary pain location… in this example; let’s say it was their shoulder. After the shoulder pain was reduced, they would suddenly have strong sensations in the knee. After treating the knee and reducing the sensation of discomfort, they would then take notice of their neck.
Over the years, I have also found it very helpful during the history taking process, to find out what position their body was in at the time of impact. This is key in determining which muscles have been most affected. Was their head turned to the left or right? Was it facing straight ahead? Did they have one or two arms on the steering wheel? Was their arm gripping tight and pushing into the wheel? Was their torso rotated to one side or the other? The position of the body determines which muscles were in a contracted state at the time of impact. If the muscles were shortened or contracted, the force of pulling or tearing can be greater. So, the potentially violent force is asking the muscle to elongate very quickly. Therefore, the injury can be great in areas where this occurs against shortened or contracted muscle fibers.
As with whiplash, muscle spasms and limited range of motion may be present shortly after the injury, or days later. Since many neck muscles have multiple actions, whiplash is likely to affect most of all of the neck muscles in some way. Whiplash may also involve impingement (pinching) of spinal nerves or cervical spinal cord injury as well. Because the likelihood for serious injury to neurological structures is high, it is always a good idea for the client to have an evaluation by a physician in order to rule out more serious pathology (something that is not normal).
If the primary problem is with neck muscle spasm, massage applications can be very helpful. Cold applications and rest from any movements that increase discomfort can help. After the initial or acute stages of the injury, heat can be helpful to create a sense of pain relief and to enhance relaxation.
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